Define

Aneurysm

Weak areas in arteries that balloon out from the arterial wall. Rupturing is highly possible and deadly.

Where are aneurysms typically found?

( where in the brain......)

What are 3 surgical treatments when dealing with an aneurysm?

1. Clipping the neck of it to isolate from the parent vessel.

2. Reinforce the sac of the defect with synthetic materials.

3. Ligating one of the feeding vessels.

 Starting from "skin", name the layers of the cranium 

Skin,

Fat,

Periosteum,

Bone,

Dura mater,

Subdural space,

Arachnoid mater,

Subarachnoid space,

Pia mater

Once the scalp and bone flaps are turned, the dura is retracted using.........

Dura Sutures

_______________ is split by bipolar cautery to seperate ________ and ________

lobes.

Lateral sulcus ( Sylvian Fissure),

Temporal,

Frontal lobes

Brain Spoons are used how?

Placed and secured in self retaining retractors to safely gain visualization of the optic nerve and chiasma.

After microdissection of the operative area, the_______of the aneurysm and the __________ __________ must be exposed.

neck,

feeding vessels

What may be necessary to prevent vasospasm?

Papaverine

What 2 ways may a temporary aneurysm clip be utilized?

1. Test possible placement before using a permanent.

2. To occlude parent vessel if rupture occurs and the neck can't be visualized for permanent clip to be placed.

What must the anesthesiologist do before permanent clips will be used?

Lower the patient's blood pressure

Once a clip has been________, it cannot be ______ and used again

opened,

closed

What is done to check for proper positioning and leakage?

Intraoperative angiogram w/ c-arm

During closures, what layers is the drain placed between?

Between the Dura closure and the bone flap closure.

How long will the patient be monitored after surgery?

24 to 48 hours in ICU with no complications